Abstract:

Objective To assess the medication adherence in patients with type 2 diabetes with electronically monitored medicine bottles and the adherence scale and explore the association between results from electronic monitoring and the adherence scale. Methods The oral hypoglycemic medication in 373 patients with type 2 diabetes was monitored with electronic medicine bottles and related demographic and blood glucose data were collected. Patients were assessed with Chinese revised version of 8-item Morisky medication adherence scale (MMAS-8) and beliefs about medication questionnaire (BMQ-specific). Results ①The average medication adherence in patients monitored with electronic bottles was (80.5±24.8)%, 64.9% (242) of which had high medication adherence (medication rate≥80%). The medication adherence in patients taking 3 kinds of hypoglycemic medications or taking medications 3 times a day was the lowest. ②The average score of MMAS-8 was 7.06±1.13. Patients with low (<6), intermediate (≥6 and <8), and high (=8) medication adherence accounted for 11.8% (43), 58.3% (218), and 29.9% (112), respectively. The average score of BMQ-specific was 6.02±3.99 and the score of specific-necessity item was significantly higher compared with the specific-concerns item (P=0.000). ③The fasting blood glucose and glycosylated hemoglobin levels in patients with high medication adherence were lower (electronic monitoring, P=0.038, P=0.015, respectively). The differences in medication rate (electronic monitoring) and glycosylation level in patients with different levels of medication adherence assessed by questionnaires were not statistically significant (P=0.725). Patients with high medication adherence assessed by both scale and electronic monitoring had the best control over blood glucose with a glycosylated hemoglobin level of (6.79±1.12)%. Patients with high medication adherence assessed by scale and with low medication adherence assessed by electronic monitoring had the highest glycosylated hemoglobin level of (7.52±1.50)%. Conclusion Medication types and medication frequency affect the medication adherence. The scale assessment overestimates the actual medication adherence in patients. The consciousness of adhering to orders for rational and persistent medication in some patients still needs enhanced. Concerns of taking medication (such as adverse effects and drug dependence) greatly affect the medication behavior in patients, and psychological counseling and medication education need to be strengthened. Patients with low actual medication adherence and overestimated medication adherence have poor control over their blood glucose.

Key words: type 2 diabetes, medication adherence, electronic monitoring, scale assessment